CAJ | 학술논문

目的：分析宫颈癌骨髓保护调强放疗技术（BMS-IMRI）的物理剂量学特点，探讨其保护骨盆骨髓（PBM）的价值。方法选择接受根治性放疗的ⅡA～ⅢB期宫颈癌患者9例，分别设计 BMS-IMRT和三维适形放疗（3D-CRT）计划进行治疗， BMS-IMRT计划要求骨盆骨受量符合以下标准：体积（V）10＜90％、V20＜76％、V40＜40％。结果与3D-CRT计划比较，BMS-IMRT计划骨盆骨的 V10、V20和 V40均明显下降[（80．9±3．4）％ vs．（93．2±2．7）％、（64．9±3．9）％ vs．（87．8±3．2）％、（17．6±3．5）％vs．（31．9±4．1）％，P＜0．01]；同时直肠、膀胱、小肠的剂量均明显下降（P＜0．01）。结论与3D-CRT计划比较， BMS-IMRT计划在不降低传统危及器官剂量限制标准的前提下，可明显的降低骨盆骨受量。
목적：분석궁경암골수보호조강방료기술（BMS-IMRI）적물리제량학특점，탐토기보호골분골수（PBM）적개치。방법선택접수근치성방료적ⅡA～ⅢB기궁경암환자9례，분별설계 BMS-IMRT화삼유괄형방료（3D-CRT）계화진행치료， BMS-IMRT계화요구골분골수량부합이하표준：체적（V）10＜90％、V20＜76％、V40＜40％。결과여3D-CRT계화비교，BMS-IMRT계화골분골적 V10、V20화 V40균명현하강[（80．9±3．4）％ vs．（93．2±2．7）％、（64．9±3．9）％ vs．（87．8±3．2）％、（17．6±3．5）％vs．（31．9±4．1）％，P＜0．01]；동시직장、방광、소장적제량균명현하강（P＜0．01）。결론여3D-CRT계화비교， BMS-IMRT계화재불강저전통위급기관제량한제표준적전제하，가명현적강저골분골수량。
Objective To compare bone marrow-sparing intensity-modulated radiotherapy(BMS-IMRT)techniques with three-dimension conformal radiotherapy(3D-CRT)techniques in cervical cancer treated with definitive whole pelvic radiotherapy,and to explore its advantage to protect the pelvic bone marrow.Methods Nine patients staged ⅡA~ⅢB cervical cancer were included. BMS-IMRT plans and 3D-CRT plans were created and compared.Dose constraints of pelvic bone for BMS-IMRT plans including:V10<90%,V20<76%,V40<40%.Results Compared with 3D-CRT plans,BMS-IMRT plans significantly reduced the volume of pelvic bone at 10 Gy,20 Gy,40 Gy dose levels [(80.9±3.4)% vs.(93.2±2.7)%,(64.9±3.9)% vs.(87.8±3.2)%,(17.6± 3.5)%vs.(31.9±4.1)%,P<0.01],while BMS-IMRT plans significantly reduced the volume of rectum,bowel,bladder at various dose levels(P<0.01).Conclusion BMS-IMRT plans significantly reduced the volume of pelvic bone marrow irradiated compared with 3D-CRT plans in patients with cervical cancer.In addition,BMS-IMRT did not compromise the sparing of other OARs.